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Gout treatment ‘not effective on diabetes related kidney disease’

A drug which researchers thought might help slow the development of chronic kidney disease (CKD) is not as effective as they had hoped.

The promising drug, Allopurinol, is usually prescribed to treat gout, an inflammatory condition caused by excess uric acid, a compound found in the blood.

Because there an association has been found between kidney disease in type 1 diabetes and increased amounts uric acid, the research team thought the medication might help slow down its progression.

They recruited 530 people with type 1 diabetes and early-to-moderate kidney disease for the R Preventing Early Renal Loss in Diabetes (PERL) study.

However, the results which have been published in the New England Journal of Medicine have shown that the drug did not produce the clinical benefits that the team had hoped for.

Lead researcher of the study Dr Alessandro Doria, from the Joslin Diabetes Center’s Section on Genetics and Epidemiology, said: “This is not the result that we wanted, but it does give a very clear answer to an important scientific question.”

During the trials, the researchers measured the kidney function by using glomerular filtration rate (GFR), this records how much blood is filtered every minute by the kidneys.

GFR drops as kidney disease progresses and over the course of the three-year project the levels of uric acid were reduced by 35 per cent.

Dr Doria said: “But despite this very nice reduction in uric acid, we could not see any effect on GFR.”

A second trial carried out by Australian researchers on people suffering from different stages of kidney disease had similar results.

Although the results were disappointing, Joslin researchers are continuing to investigate other ways treatment paths to slow the progression of diabetes-related kidney disease.

Dr Doria added: “PERL was a textbook example of using epidemiology to find treatment targets, and then designing a study to translate those findings and try to find a new intervention.

“In this case, it didn’t work. But this is exactly why we do epidemiological studies, and how our scientific understanding advances.”

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